Vim & Vigor - Winter 2017 - University of Virginia - 19

HOW CARDIAC
REHAB WORKS

What Cox didn't know then is
that anyone who has had a heart attack,
heart surgery or another serious heartrelated condition can benefit greatly
from cardiac rehab. It's a program of
exercise, nutrition and stress reduction
designed to help gradually improve the
health of the heart.
Phase 1 of cardiac rehab begins in
the hospital, says John Osborne, MD,
PhD, a cardiologist and spokesman for
the American Heart Association. This
phase involves getting the patient out
of bed in addition to providing hearthealth education.
Then, phase 2 is typically three
times a week at a rehab facility for
12 weeks. During this time, the patient
might do resistance training, ride a
stationary bike and walk on a treadmill. Over time, as the heart gets
stronger, "your exercise is gradually
increased," Osborne says.
Participants are monitored closely
during exercise. Their blood pressure
and heart rhythms are checked constantly. Counseling on diet and lifestyle
factors is also a key component.
And while the physical benefits of
cardiac rehab are undeniable, Osborne
says, the camaraderie and support of
these programs are just as important.
For Cox, the upbeat, encouraging
staff at her cardiac rehab facility and
the supportive fellow participants made
a difference.
"If I wasn't having a good day, I
could go to cardiac rehab and feel better. The whole thing just lifted my
spirits," she says. "I was working to
do better, and there were other people
doing the same thing."
Phase 3 of cardiac rehab is more
open-ended, Osborne says. Patients typically exercise on their own at the same
facility where they completed phase 2;
it's an ongoing maintenance phase to
keep up the gains made. Cox, now 68, is
in phase 3.

WEBSITE

Learn More About Helping Your Heart
Want to better understand the benefits of cardiac rehab? Check out the
treasure trove of resources at the American Association of Cardiovascular
and Pulmonary Rehabilitation. Go to aacvpr.org, then click "Resources,"
followed by "Resources for Patients" and follow the cardiac rehab link.

GIVING IT
A CHANCE

Studies have shown that
cardiac rehab leads to a reduced risk of
both hospital readmission and death, in
addition to lower anxiety, depression,
hostility and stress.
"Cardiac rehab has been shown to
have a dramatic effect on recovery,"
Osborne says.
Even so, a lot of patients don't go.
Experts estimate participation rates to
be around 20 to 30 percent. For some,
the time commitment and insurance
challenges are barriers, but those can be
figured out, Osborne says. The important thing, he notes, is for physicians to
make the referral and for the patient to
be motivated and engaged.
When he works with patients,
Osborne strives to make sure they
understand the importance of rehab in
the recovery process.
"I say, 'The single most important
thing you'll do is cardiac rehab,' " he
says. "I drum that message in every
time I see them so they understand this
is important."
For Cox, despite her early skepticism,
cardiac rehab made a difference. Her
ejection fraction percentage, which was
20 when she left the hospital, returned
to 40 percent after several weeks of
cardiac rehab.
"That's back to where I was before the
congestive heart failure diagnosis," she
says. "I cried when I found out. I'd never
dreamed I'd get back to that." ■

MAXIMIZE
YOUR REHAB
POWER
You've accepted the referral, and
you're ready for cardiac rehab. Now
how do you get the most out of
this experience?
Here are a few ideas from
Carly Goldstein, PhD, a member
of the American Association of
Cardiovascular and Pulmonary
Rehabilitation's Psychosocial and
Nutrition Expert Group.
3 Indulge in the support. It's
natural to experience anxiety after a
cardiac event, but there's an upside.
"Realize that you're the most supported you'll ever be in making a
behavior change," Goldstein says.
Harness that energy.
3 Monitor your health. "We
know people do better at changing behaviors when they monitor
their behaviors," Goldstein says.
That could be using an app or a
journal to record stress, exercise
or food. Then, study the data with
your doctor and work on improving
your habits.
3 Take full advantage. Some cardiac rehab programs include access
to behavioral health professionals,
dietitians and other resources. "If
you're in a program that has those
ancillary services, don't be bashful,"
Goldstein says. "These professionals
can be helpful."

WINTE R 2017

19


http://www.aacvpr.org

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